The potential health and economic impact of implementing a medically prescribed heroin program among Canadian injection drug users.
The potential health and economic impact of implementing a medically prescribed heroin program among Canadian injection drug users.
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DOI：
10.1016/j.drugpo.2004.04.001
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发表时间：
2004-01-01
影响因子：
4.4
通讯作者：
Hogg, R. S.
中科院分区：
文献类型：
--
作者：
Miller, C. L.;Schechter, M. T.;Hogg, R. S.
目的：模拟实施医用海洛因处方计划(MHPP)对健康和经济的潜在影响。方法：我们模拟了MHPP在5年内的潜在影响。如果参与者注射非法药物超过5年，至少每天注射海洛因，居住在大温哥华，并且之前美沙酮维持治疗失败，则符合条件。参数估计从瑞士海洛因试验研究专著中获得。通过比较MHPP方案和非MHPP方案中的住院、急诊室使用、犯罪活动成本和就业人数来估计潜在的影响。开发了两种模式，一种适用于符合条件的温哥华注射吸毒者研究(VIDUS)参与者，另一种适用于大温哥华合格的注射吸毒者。结果：在VIDUS的1400名参与者中，共有356人(25%)具有潜在的资格。在研究期间，MHPP方案导致符合条件的VIDUS参与者的住院天数(从4041天减少到1477天)和急诊室就诊次数(从3088次减少到1129次)以及刑事指控(从1343次减少到516次)显著减少。就业从4.8%温和上升至7.1%。MHPP的实施可能会将医院、紧急情况和犯罪活动的成本降低63%，或每个治疗对象减少9650美元。估计大温哥华省下的总成本由6 957 000元至9 050 700元不等。结论：我们的模型表明，通过在加拿大实施向慢性注射吸毒者开出医用海洛因处方的计划，可能会产生显著的健康和经济利益。
Objective: To model the potential health and economic impact of implementing a Medical Heroin Prescription Program (MHPP). Methods: We modeled the potential impact of a MHPP over a 5-year period. Participants were eligible if they had injected illicit drugs for greater than 5 years, injected heroin at least daily, resided in Greater Vancouver, and have previously failed Methadone Maintenance Therapy. Parameter estimates were obtained from the Swiss Heroin Trial study monograph. The potential impact was estimated by comparing hospitalization, emergency room use, and criminal activity costs and employment numbers in a MHPP and non-MHPP scenario. Two models were developed, one for eligible Vancouver Injection Drug Users Study (VIDUS) participants and one for eligible injection drug users in Greater Vancouver. Results: A total of 356 (25%) of the 1400 participants in VIDUS were potentially eligible. The MHPP scenario led to a notable decrease in hospital days (from 4041 to 1477) and emergency room visits (from 3088 to 1129) as well as criminal charges (from 1343 to 516) among eligible VIDUS participants over the study period. Employment moderately rose from 4.8% to 7.1%. The implementation of an MHPP could potentially decrease hospital, emergency, and criminal activity costs by a 63% reduction, or $9650 per treated subject. Estimated total cost savings for Greater Vancouver ranged from $6 957 000 to $9 050 700. Conclusion: Our model indicates that notable health and economic benefits could potentially occur by implementing a programme that prescribes medical heroin to chronic injection drug users in Canada.